Why the Coronavirus Pandemic May Trigger Disordered Eating

Is the Pandemic Making You Restrict or Binge? Experts Explain Why (and You're Not Alone)

The novel coronavirus outbreak is affecting us all in different ways. And for some, the disruption in routine, the uncertainty and anxiety about work or finances, the stress from juggling working from home and homeschooling, or the worry about loved ones can be so overwhelming that it's affecting how we eat.

Experts agree that you're not alone if you're coping by using food. Maybe you've lost your appetite, are overeating, or are stress baking and emotionally eating. You may suddenly be showing symptoms of disordered eating such as hoarding or bingeing, or you may be reverting back to old eating disorder patterns you've previously recovered from, such as following restrictive food rules. Experts explain the five reasons this pandemic can affect your relationship with food and offer advice on what you can do to prevent harmful thoughts or habits.

Reason 1: Isolation and Silence Can Make Disordered Thoughts Louder

"Feeling socially isolated can be quite devastating for human beings," said BACP-accredited eating disorder therapist Harriet Frew, MSc. Obsessive thoughts about food and body image can become stronger, and for those who've had issues in the past, she said "the eating disorder can start to fill the isolation void and take a larger grip again."

Being isolated at home alone brings different challenges to being isolated with others, explained psychotherapist Lynsey McMillan, MSc, who specialises in disordered eating. "For those living alone there is the potential for loneliness to trigger eating disorder behaviours," she said. Since a lot of bingeing happens in private, and that coupled with a loss of routine which can disrupt mealtimes, it makes chaotic eating and eating at odd or infrequent times more likely. "Along with this there might be disruption to other daily rhythms such as sleep and getting outside," McMillan said.

She added that being in quarantine with others could also trigger disordered eating behaviours. There might be an increase in restriction if a person feels they can't freely eat in the way they need to, either because of feeling observed and perhaps criticised by family or housemates, or because they may feel they can't use up vital supplies of foods when there is a need to more carefully ration. "Friction within households are common triggers for disordered eating and families could feel under extra strain right now," McMillan added.

"Many people are experiencing emotional stress right now because of the temporary food scarcity caused by COVID-19 panic-buying in some areas, and also because of the scarcity mindset that's affecting many people during this pandemic," said Christy Harrison, MPH, RD, CDN, an antidiet registered dietitian nutritionist, certified intuitive eating counsellor, host of the Food Psych Podcast, and author of Anti-Diet.

"Seeing other people hoarding food may trigger an increase in anxiety, and fears could include worries about not being able to access their 'safe' foods, and conflict around competitively stocking up themselves," added McMillan. "I've heard from quite a few people who feel like they can't let themselves eat as much as they really want right now, because they're afraid they'll run out of food," Harrison said. People's fear and panic about running out of food is still making them feel restricted and deprived, and this can also trigger binging.

"Our bodies have cleverly evolved survival responses against famine which in situations of scarcity or threat of scarcity kick in to protect us," McMillan explained. It's a common adaptive response, for example, to eat past fullness, eat in a hurried way, or to be very preoccupied with obtaining food if there is a sense of scarcity. For those who are buying a couple week's worth of groceries at one time, having that much food in the house can trigger a binge if you've had a prior tendency to.

Reason 3: Food Rules Are Being Challenged

Food rules help people to reduce anxiety and feel a sense of structure, control, and simplicity in the face of countless (and for the disordered eater, overwhelming) daily food decisions, explained McMillan. "We are now faced with an increase in food dilemmas and buying habits have had to adapt overnight. With this, previous food rules may be impossible to adhere to or may mutate into new rules or other behaviours," she said. Either way it could feel scary or chaotic and it's likely that for some who can't meet their self-imposed rules (like eating no carbs), there could be a feeling of failure or panic. "This can lead to an increase in restriction and later bingeing, which can become a cycle of restrict-binge-restrict," McMillan said.

"People don't have access to their usual foods in quite the same way," added Frew, and "this can create anxiety around food, as you might feel safe when only eating specific items." She added that on top of that, people may be feeling pressure to work out at home and to avoid weight gain during lockdown. Therefore food rules might be increasing or intensified in an attempt to avoid this. Frew said people who wouldn't normally exercise can feel drawn into home workouts, and if you've had a previous problem with over-exercise, this can be re-triggered.

Reason 4: Lack of Regular Routine Can Make Someone Feel Out of Control

Our work, the people we interact with on a regular basis, the things we do to let off steam, hobbies, interests — all of these have been impacted by the coronavirus and social distancing. McMillan explained that these routines helped us have a sense of self and purpose, and a way to have a sense of order and control in life, which in turn helps us to manage our emotional world.

"For all of us at the moment, it can feel like we've suffered a series of losses," McMillan said. For someone with disordered eating or in recovery, these swift changes and the emotional roller coster that comes with it, can threaten to destabilise recovery. Not being able to attend a support group, or see your dietitian or therapist (either in person or at all), can trigger powerful emotions such as anger, fear, loss, isolation, sadness, or rejection, leading to bingeing or other eating disorder behaviours to try to numb these painful emotions. She added that not being able to exercise at the gym, your swimming pool, public tracks, or attend classes can mean people restrict more in an attempt to compensate, or they worry far more about any food they consume.

Frew added that if you have more time on your hands now, not having your usual distractions and routine could mean becoming more preoccupied with food. You might also be vulnerable to binge eating or emotional eating if you're bored because of lack of structure. Anxiety and other emotions might make you not feel like sticking to your regular mealtimes, and you snack all day instead. And instead of nourishing foods, you're more likely to crave high-sugar foods that will offer you a quick dopamine hit.

Reason 5: Less Access to Support Can Cause Falling Back to Old Habits

"It's easy for the eating disorder voice to become stronger, as there is less opportunity to get a different perspective or to be around others modelling a healthy relationship with food," Frew said. If you're unable to see your dietitian or therapist regularly, not being able to talk openly about feelings can mean that these get directed into old ways of coping through food.

Not having access to support could make symptoms worsen, McMillan said. Although many therapists have made the move to online or telephone support, people can slip through the cracks if they don't feel as motivated to follow through or if they're unable to do so because of financial, family, or other issues.

"There could be an increase in feelings of hopelessness. So much of my work is to engender hope and encourage clients to persevere in the face of what can be a long road to recovery," McMillan said. This pandemic has put us in uncertain territory where we can't tell clients when we can see them face to face, or when their support group might restart. "This not knowing can trigger catastrophic thinking. It's common for disordered eaters to hold all or nothing thinking habits, and so no help at the moment might feel like no help ever," she said.

Tips to Help Prevent or Halt Disordered Eating Behaviours

You're not alone: Knowing that other people are experiencing the same thoughts and feelings might make you feel better. "People's stress levels are elevated because of the pandemic, and it's OK if your eating is a little weird right now because of that," Harrison said.

Seek out support: Although we might be isolated at home, reach out to family, friends, coworkers, or a therapist so you don't feel isolated. Talk openly about your worries, your concerns, your fears — having someone listen can make you feel better.

Get back on a routine: While you won't be able to mimic the exact routine you followed before the coronavirus, establishing a new routine you can stick to every day will help you regain some of the control you feel like you've lost.

Listen to your body: "It's important to listen to your body's hunger and fullness cues and honour them to nourish yourself and help keep anxiety at bay," said registered dietitian Rachel Berman, general manager of Verywell. Harrison added that if you find yourself eating to self-soothe a lot these days, know that it's totally normal and understandable. It could also be a sign that you were depriving yourself before the pandemic, and the solution is not to clamp down and try to control your eating, but to ease up and stop the deprivation.

Do what makes you happy: Find ways to celebrate this time at home. Designate an hour or so each day to do something you're passionate about, something that brings you joy, reduces stress, and that gives your life meaning. Get creative by drawing or playing an instrument, read a book, get outside for a walk, or start that passion project you've never had time for (mine is writing a children's book!).

Show yourself love: McMillan said to use this time as an "opportunity to learn to slow down and prioritise self-compassion." It's so important to offer yourself kindness, patience, and sensitivity right now. Judging or criticising how you're handling this worldwide pandemic will only lead to feelings of failure, so give yourself credit for your effort and realise this is new to all of us and you're doing the best you can (which is amazing, by the way!).

This too shall pass: "It's vital to keep reminding ourselves that this situation is temporary," McMillan said. We will get through this, so hang in there and maintain your hope that better days will soon be here.